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Regression in left ventricular mass after aortic valve replacement for chronic aortic regurgitation is unrelated to

Morgan L Brown1, Hartzell V Schaff, Rakesh M Suri

  • 1Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada.

The Journal of Thoracic and Cardiovascular Surgery
|November 16, 2010
PubMed

Insights

Prosthesis-patient mismatch does not impact left ventricular mass regression after aortic valve replacement for aortic regurgitation. Greater regression occurs in patients with higher preoperative left ventricular mass, though normalization is not always achieved.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Echocardiography

Background:

  • Chronic aortic regurgitation leads to left ventricular (LV) volume overload.
  • Aortic valve replacement (AVR) is performed to correct this, aiming for LV remodeling.
  • Prosthesis-patient mismatch (PPM) may influence post-operative outcomes.

Purpose of the Study:

  • To investigate the impact of PPM on LV mass regression after AVR for chronic aortic regurgitation.
  • To identify predictors of LV mass regression in this patient population.

Main Methods:

  • Retrospective analysis of patients undergoing AVR for chronic aortic regurgitation.
  • Exclusion criteria included moderate/severe aortic stenosis, CABG, or mitral valve surgery.
  • Preoperative and follow-up echocardiograms were used to measure LV mass and assess PPM.

Main Results:

  • LV mass regression averaged 50 ± 38 g/m(2) at 3.2 ± 2.4 years post-AVR.
  • Regression was independent of indexed prosthetic valve area and PPM.
  • Higher preoperative LV mass was the strongest predictor of greater LV mass regression (P < .001).

Conclusions:

  • LV mass regression after AVR for aortic regurgitation is not influenced by indexed prosthetic valve area or PPM.
  • The extent of regression is primarily determined by the initial degree of LV hypertrophy.
  • Despite significant regression, LV mass may not normalize in patients with severe preoperative hypertrophy.
Abstract

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